组织多普勒对左室射血分数正常的心力衰竭患者左室功能的测定

目的 应用超声测量左室射血分数（LVEF）正常的心力衰竭（以下简称心衰）患者的Sm、Ea、Aa、E／Ea比值，分析患者左心室功能与血浆B型利钠肽（BNP）水平之间关系。方法收集住院心衰患者100例，LVEF正常心衰组和LVEF降低心衰组各50例，50例健康体检者入选为对照组。比较各组Sm、Ea、Aa、E／Ea比值、BNP浓度的差异。结果正常对照组、LVEF正常心衰组、LVEF降低心衰组的Sm值依次下降，与BNP水平呈负相关（r=-0．35，P〈0．05）；E／Ea比值依次上升，与BNP水平呈正相关（r=0．728，P〈0．05）。结论通过组织超声多普勒测定的E／Ea比值，有助于LVEF正常心衰组患者的诊断。

Decect of left ventricular dysfunction in patients with heart failure with normal ejection fraction with tissue Doppler echocardiographic

Objective To determine whether patients with suspected heart failure but preserved left ventricular ejection fraction （LVEF） had systolic and diastolic dysfunction in left ventricular long axis detected by tissue Doppler echocardiographic indexes. Methods The data of 100 patients with heart failure who admitted to our hospital between August 2007 and October 2009 were collected. Heart failure with preserved LVEF was diagnosed in 50 patients and heart failure with reduced LVEF was diagnosed in another 50 patients. Fifty age - matched healthy subjects served as the control group. Tissue Doppler imaging indexes （Sin, Ea, Aa, E/Ea） and plasma BNP concentration were compared among the three groups. Results The degree of Sm decrease was more significant in heart failure patients with reduced LVEF than those with preserved LVEF. In the two subjects, the index Sm was negatively correlated with the BNP concentration （ r = - 0.35, P 〈 0.05 ）. The indexes E/Ea was positively correlated with the BNP concentration （ r = 0. 728, P 〈 0.05 ）. Conclusions The LV filling index E/Ea is identified as the best index to detect diastolic dysfunction in heart failure but preserved left ventricular ejection fraction.